In Billing
Jan 25th, 2017
Locum tenens is a Latin phrase that means, “to hold the place of.” In medicine, locum tenens are contracted physicians who substitute for a physician who has left the practice, or who is absent or otherwise unavailable. The Centers for Medicare & Medicaid Services (CMS) allows payment to the regular physician for services provided during ...
Jan 20th, 2017
The American Health Lawyers association reported the following in its weekly Fraud and Abuse update: The government won or negotiated more than $2.5 billion in healthcare fraud judgments and settlements in fiscal year (FY) 2016, the Departments of Health and Human Services (HHS) and Justice (DOJ) said in their Health Care Fraud and Abuse Control Program Annual ...
In Audit
Jan 19th, 2017
In the 2017 Work Plan, the Office of Inspector General (OIG) is reviewing Medicare’s billing and reimbursement integrity for two diagnosis-related groups (DRGs): inpatient claims for kwashiorkor diagnosis and mechanical ventilation. Kwashiorkor is a severe protein malnutrition that usually “affects children living in tropical and subtropical parts of the world during periods of famine or ...
In Audit
Jan 10th, 2017
If you haven’t stumbled on the treasure trove of information in the Office of Inspector General’s (OIG) Media section of their website, it’s time you found it. OIG now keeps you informed on fraud, enforcement, and compliance via podcast. The podcasts are found on the OIG website with Mike Kane, Office of External Affairs, discussing the monthly ...
In Billing
Jan 9th, 2017
A final rule effective July 13, 2017, which the Centers for Medicare & Medicaid Services (CMS) maintains will improve home health care while streamlining providers’ requirements, has been published in the Federal Register.   Home health patients receive coordinated services ranging from skilled nursing to physical therapy to medical social services, all under the direction of ...